Virus or Vaccine or other Virus – An investigation into the Flu Shot

The free—for most—Tumbler Ridge Flu Clinic will be held Nov. 6, 2012 at the Community Centre. It is a publically funded clinic for individuals who meet certain requirements.

This group includes, but is not limited to, healthy children six months to 59 months of age, contacts and caregivers of children less than five, seniors aged 65 and older as well as their caregivers, and people with chronic health conditions such as cardiac or pulmonary disease, diabetes, cancer, chronic kidney or liver disease and finally, anemia or hemoglobinopathy. To see if you apply for a free flu shot, check the Northern Health website.

What is the flu and how is it diagnosed? The flu season typically runs from late November into early March. Contrary to common perception, the flu has many of the same symptoms as a cold and it is very difficult to diagnose. The only main difference between flu and cold symptoms is with the flu, a person will have a fever of higher than 100 F. Also, vomiting and upset bowels are common, though sometimes flu symptoms are more likely symptoms of a gastrointestinal virus, not the flu. This misconception is made due to the term ‘stomach flu’, which is not ‘the flu’ but rather a slang term for a gastrointestinal virus.

The BC government has implemented measures in an attempt to better protect patients and seniors from being exposed to influenza. A notice from the BC government released in the summer says, “Beginning this year, healthcare workers who come into contact with patients at publicly-funded healthcare facilities or in the community, including long-term-care facilities will need to get the influenza vaccine, or wear a mask during the flu season.”

Dr. Perry Kendall, BC’s Provincial Health Officer says, “Influenza causes more deaths annually than all other vaccine-preventable diseases combined, and hospitalized patients are more vulnerable to complications from influenza than the general population,” he continues, “This policy will protect patients. Putting in place consistent policies to prevent influenza from spreading is the right thing to do from a patient safety perspective.”

According to the Northern Health Influenza information database about 1,400 people die annually from influenza and pneumonia. However, Dr. Ronald Chapman, Chief Medical Officer for Northern Health says the numbers are more around 4,000 to 8,000. How, is it possible the number of deaths recorded from the flu could range by 6,600 mortalities?

In BC last year, 40 percent of Acute Care facility workers received the influenza vaccine. More locally, about 37 percent of Northern Acute Care facility workers partook in the vaccination. These figures are from the BC Centre for Disease Control. The province was looking for a 60 percent vaccination rate for these healthcare workers, which was not met. This begs the question, if healthcare workers have free vaccinations available to them, why are they not getting it done?

A healthcare worker from the Peace Region says, “They show us a piece of paper which outlines to us all of the different side—effects. The side—effects can last anywhere from zero up to 80 days. Some of them are pretty severe, including cellulitis, high fever, flu-like symptoms; there were a ton of side effects.”

Dr. Chapman on the other hand says the only side—effect is minimal. He says, “The flu vaccine which is injected into people is comprised of dead virus particles. They cannot make you sick. The only side effect is a sore arm.”

These statements are contradictory. The healthcare worker continues, explaining what happened to them when they did receive their vaccination. “From my experience, and a lot of others I have spoken to, the only time they received their one flu shot, they got really sick. I was the sickest I’ve ever been, in bed, not able to move.”

Dr. Chapman says there is no correlation between getting a flu shot and getting sick. Chapman says, “Why people often get sick is there are a lot of viruses during winter and a lot will give you flu-like symptom. Maybe what happens is people get vaccinated and get infected with these other viruses and get similar symptoms to the flu, but it’s not the flu virus causing it. We don’t vaccinate people against some of the other common viruses that go around.”

Dr. Chapman said in his opinion, the flu shot does not lower your immune system, thus making it easier for other viruses to get at you. There must be a reason why many people have gotten ‘flu-like’ symptoms the only year they got a flu shot, but for now, that along with any long-term effects of getting the flu shot, remain a mystery.

The flu shot is still relatively new having been around for about ten years and it is not foolproof. It does not stop people from getting the flu, it lowers their chances. The release from the Government of BC states, “The influenza vaccine helps to prevent infection in healthy adults by up to 80 percent.”

When asked their thoughts about the mandatory flu shot or the need to wear a mask, the healthcare worker says, “It should be the healthcare worker’s decision. They are giving us that option by saying we can wear a mask. Now, if we get a flu shot we have to put a little certificate on our ID badge that says we have been vaccinated. It should be confidential for anyone, including healthcare workers.”

This initiative, for some healthcare professionals seems like a feeble effort to protect patients from illnesses. The healthcare worker interviewed says, “For them to say they are going to be looking at our record for the flu alone is almost a joke. They don’t know the long-term effects of this vaccination.”

For some in the healthcare profession, the side effects from the vaccine itself make them not want to partake. The healthcare worker says, “They tell us we probably wouldn’t feel very good for 48 to 72 hours after the vaccine. If I am around anyone who coughs on me during that time, I am more at risk. The flu is just one thing. There have been gastrointestinal viruses (diarrhea, vomiting) that have kept people from coming to work. We are not supposed to come to work if we have any symptoms at all.”

Dr. Chapman says one of the issues about the flu is that you can be infected and not know for up to 24 hours. He says, “You could be infecting patients who are vulnerable. I endorse it and I support it. We want to make sure our patients come to a safe environment.”

Aside from the flu, patients and healthcare workers in Acute Medical facilities, i.e. hospitals, are exposed to far more serious illnesses. The healthcare worker says, “Flu aside, there are so many other viruses, bacteria, superbugs, that we are exposed to every single day. They have no way of tracking these, and there are no vaccines to give us. There is a screening tool we use in hospitals for VRE [Vancomycin-Resistant Enterococci] and MRSA [Methicillin-Resistant Staphylococcus Aureus]; the superbugs. Everyone who has been admitted to a healthcare facility is screened for this. We take swabs and send them off to get results. If infected, the person is isolated. Healthcare workers are not screened. We are exposed to so many different things and there is no annual screening for those. I’m not saying the healthcare worker will make patients sick,” the worker continues, “but let’s say you got into an accident and had a gaping wound in your abdomen that needed to be dressed every day. It would be really pertinent you had someone who was completely sterile to prevent the spread of MRSA. MRSA is a bug that causes an infected person to be immune to antibiotics. These superbugs are dangerous.”

Dr. Chapman insists the flu is just as dangerous. He discusses the group who are most at risk. “The bulk of vulnerable people would be elderly patients, those with lung or heart problems and a small portion would be young children. People can die and it can be either the flu or from other complications. The flu can kill you.”

Though this may be true, the healthcare worker interviewed says this has not happened in the years they have worked in hospitals. The professional says, “I have never seen any of my patients pass because of the flu. Realistically, the reasons they get pneumonia are other things such as immobilization. I’ve never seen anyone come in and die from flu-like symptoms that have then developed into pneumonia.”

The new policy is in response to low vaccine coverage rates of healthcare workers, and is part of comprehensive infection control measures developed by health authorities, acting upon the advice of public health and patient safety professionals, in collaboration with the Health Employers Association of BC. Other infection control measures include rapid identification of ill patients, adherence to hand hygiene, cough etiquette, the use of antivirals during outbreaks, and asking staff to stay home when ill.

The new policy applies to all healthcare workers including health authority staff, physicians and residents, volunteers, students, contractors and vendors who come into contact with patients. BC is the first jurisdiction in Canada to implement this province-wide policy. In the United States, there are many health care organizations and jurisdictions that have made this change. Vaccination rates for BC healthcare workers have historically been less than 50 percent.
Precautionary Suspension of Novartis Vaccines in BC

Following a recommendation from Health Canada to temporarily suspend use of Novartis influenza vaccine products (Agriflu and Fluad), BC has halted the use of these products in its influenza program.

As a precautionary measure, Health Canada has advised that it is recommending all healthcare facilities stop using the Novartis vaccines, based on a similar suspension of use of these products in Europe. This suspension is purely precautionary, and is based on reports of small clumping material noticed in the vaccines in Italy. There have been no adverse effects related to these vaccines, and no concerns have been seen with supplies already used here in Canada or BC.

British Columbia is fully complying with this suspension, and will be stopping use of these vaccines immediately. The BC Centre for Disease Control has issued a notice to all health authorities advising them of this measure.

Novartis products represent about 30 percent of BC's provincial flu vaccine supply. Public health officials here in BC are working with their colleagues across the country to establish next steps on public vaccination programs.